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Background <p>Figure-of-eight bandages (F8B) and arm slings are common treatments for midshaft clavicle fractures (MCF), yet the optimal approach remains uncertain due to conflicting evidence. This meta-analysis compared their effectiveness in adult patients.</p> Methods <p>A literature search of PubMed, Scopus, Cochrane, and Google Scholar was conducted through July 2025. Four RCTs and two retrospective studies involving 688 adults were included. Assessed outcomes included pain (VAS), Constant score, union time, clavicle shortening, nonunion, dissatisfaction, and other complications.</p> Results <p>Pain levels were comparable between groups at 1 and 3&#xa0;weeks (<i>p</i> = 0.07 and 0.42). Constant score at 3&#xa0;years was significantly higher in the F8B group (<i>p</i> = 0.01), but the MD of − 1.69 is below the threshold for clinical relevance. Similarly, although F8B was associated with significantly less clavicle shortening (<i>p</i> = 0.02), the difference of 0.80&#xa0;mm is likely within the margin of measurement error and not clinically meaningful. Healing time showed no significant difference (<i>p</i> = 0.70). Patient dissatisfaction and nonunion rates were lower in the F8B group but not statistically significant (<i>p</i> = 0.11 and <i>p</i> = 0.33). F8B demonstrated a significantly lower risk of pooled complications including malunion, displacement, and skin discomfort (<i>p</i> = 0.007).</p> Conclusion <p>F8B may offer modest advantages in alignment and function, but current evidence does not justify its routine use over slings. Further high-quality, patient-centered studies are needed to guide individualized care.</p>

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Figure-of-Eight Bandage Versus Arm Sling for the Conservative Treatment of Midshaft Clavicle Fractures in Adults: A Meta-Analysis

  • 期刊论文

  • 发表日期：

    2025年10月13日

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  • Guy Awad,
  • Marc Boutros,
  • Christèle Asmar,
  • Tammam Hanna

摘要

Background

Figure-of-eight bandages (F8B) and arm slings are common treatments for midshaft clavicle fractures (MCF), yet the optimal approach remains uncertain due to conflicting evidence. This meta-analysis compared their effectiveness in adult patients.

Methods

A literature search of PubMed, Scopus, Cochrane, and Google Scholar was conducted through July 2025. Four RCTs and two retrospective studies involving 688 adults were included. Assessed outcomes included pain (VAS), Constant score, union time, clavicle shortening, nonunion, dissatisfaction, and other complications.

Results

Pain levels were comparable between groups at 1 and 3 weeks (p = 0.07 and 0.42). Constant score at 3 years was significantly higher in the F8B group (p = 0.01), but the MD of − 1.69 is below the threshold for clinical relevance. Similarly, although F8B was associated with significantly less clavicle shortening (p = 0.02), the difference of 0.80 mm is likely within the margin of measurement error and not clinically meaningful. Healing time showed no significant difference (p = 0.70). Patient dissatisfaction and nonunion rates were lower in the F8B group but not statistically significant (p = 0.11 and p = 0.33). F8B demonstrated a significantly lower risk of pooled complications including malunion, displacement, and skin discomfort (p = 0.007).

Conclusion

F8B may offer modest advantages in alignment and function, but current evidence does not justify its routine use over slings. Further high-quality, patient-centered studies are needed to guide individualized care.